Provider Demographics
NPI:1144699141
Name:WARREN, ALEXANDER (FNP-C)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:WARREN
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 N HUTCHINSON AVE
Mailing Address - Street 2:
Mailing Address - City:ADEL
Mailing Address - State:GA
Mailing Address - Zip Code:31620-2300
Mailing Address - Country:US
Mailing Address - Phone:229-896-2124
Mailing Address - Fax:872-299-0795
Practice Address - Street 1:110 S HUTCHINSON AVE
Practice Address - Street 2:
Practice Address - City:ADEL
Practice Address - State:GA
Practice Address - Zip Code:31620
Practice Address - Country:US
Practice Address - Phone:229-896-2124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-20
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN198239363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily